Interval versus postabortive counseling: demographic characteristics and effect of reproductive desire on method selection (14332 cases) 

K. Ertopçu, M. Inal, A. Dönmez, I. Özelmas, S. Tinar 

SSK (Social Security Agency) Aegean Maternity Hospital, Family Planning Department, Izmir, Turkey 

Objective: To compare the demographic characteristics, reproductive desire and selected contraceptive methods of cases who had applied to our clinics in interval period and for uterine evacuation of pregnancy. 

Materials and Methods: 8308 cases who had applied to our clinic for contraceptive method application in interval period and contraceptive method applied 6024 cases after uterine evacuation in between 01.01.1999 and 31.07.2003 were enrolled into the study. Demographic characteristics like age, education status, number of alive children and former contraceptive methods of the cases were recorded. Reproductive desire of the cases were evaluated. Contraceptive methods of both groups selected after counseling were analysed. Statistical data were evaluated with chi-square test. 

Results: Fiftysix percent of the applicants were graduates of primary school (This rate was 59% in the uterine evacuation group and 54% in interval group). 50% of the cases were in between 21–31 years of age (52% of the uterine evacuation group and 50% of the interval group). Cases older than 43 years were 9% of the interval group and 3% of the postabortive group. 41% of the cases had 2 children, 28% of the cases with 1 child and 20% of the cases had 3 children. 63% of the cases had no desire for more children (This rate was 66% in uterine evacuation group and 16% in interval group). The rates of the selected contraceptive methods of 14332 cases were as follows: intrauterine device (IUD) 49%, oral contraceptive (OC) 28%, Depotmedroxyprogesterone acetate (DMPA) 10%, surgical sterilization 6%, monthly injection 5% and vasectomy 2%. These rates were 58% IUD, 22% OC, 7% DMPA, 7% monthly injection and 6% surgical sterilization after the uterine evacuations. 49.4% of primary school graduates preferred IUD, 26.7% preferred OC, 11% preferred DMPA, 6.4% preferred surgical sterilization (tubal ligation), 4.9% preferred monthly injection and 1.3% preferred vasectomy. These rates were IUD in 45.1%, OC in 34.3%, DMPA in 9.8%, monthly injection in 5.7%, surgical sterilization (tubal ligation) in 3.9% , vasectomy in 0.8% of high-school graduates. IUD was the most preferred contraceptive method among all of the age groups with a rate over 50%. Fiftyone percent of the surgical sterilization applied cases had three or more children, 38% had 2 children and 2% had one child. 52.6% of 3095 cases with no previous contraceptive method preferred IUD and 21.3% preferred OC. 58.6% of the 3800 cases using coitus interreptus as contraceptive method preferred IUD and 19.2% preferred OC. 49.4% of the 1834 cases using IUD as contraceptive method preferred IUD and 27.3% preferred OC. 15.5% of the 1830 cases using OC as contraceptive method preferred OC again. IUD, OC, DMPA and monthly injection were chosen by 3050 cases (who desire children after 2 years) with rates of 49.7%, 32.5%, 12.2% and 5.5%, respectively. 

Conclusions: Socio-cultural levels of the cases applied for uterine evacuation were observed to be lower. Post-abortive counseling was found to be effective in method selection. The most frequently chosen contraceptive method was found to be IUD, whereas oral contraceptives and monthly injections were preferred more frequently than the other groups in group with high education level.